The present invention relates to surgical devices in general and in particular to a method and apparatus for performing a frenotomy.
The lingual frenum is a short fibrous length of mucosa which connects the posterior portion of the under side of the tongue to the genioglossus muscle in the floor of the mouth. Ankyloglossia (tonguetie) is a condition wherein the lingual frenum extends too far toward the tip of the tongue, attaching the tip of the tongue to the floor of the mouth, making normal speech impossible by limiting the motion of the tongue. Ankyloglossia may be treated by a lingual frenotomy (also known as an ankylotomy) wherein the anterior portion of the over extended lingual frenum is severed to free the tip of the tongue.
A frenotomy is typically performed by first pulling upward on the tongue to make taut the short fibrous lingual frenum and the underlying genioglossus muscle. The frenum, and any portion of the genioglossus muscle extending into the frenum, are then severed with scissors midway between the tip of the tongue and the origin of the frenum, the lingual surface of the symphysis of the mandible. The cut is directed posteriorly parallel to the floor of the oral cavity, extending inward for a sufficient distance (typically 1.5 to 3 cm) to allow the tip of the tongue to touch the lingual surfaces of the maxillary anterior teeth with the mouth open. The lateral edges of the surgical incision are then undermined with the scissors to separate the mucosa from the underlying muscles. The cut edges of mucosa in the floor of the mouth and on the under surface the tongue are then sutured such that the horizontal incision becomes a vertical one.
The method of the prior art is effective but has some drawbacks. It is difficult to obtain a well directed incision and the incision and undermining cause profuse bleeding, along with rolled, irregular and mismatched incision edges, making accurate suturing difficult. Also the undermining and subsequent handling of the mucosa cause a large amount of tissue damage, resulting in more postoperative swelling and pain.